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Deep Vein Thrombosis (Renal Impairment) — UKMLA MCQ

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MediumHaematologyDeep Vein Thrombosis (Renal Impairment)UKMLAMRCP Part 1PARAPSAMRCGP AKT

A 67-year-old woman is assessed face to face with clinically diagnosed community-acquired pneumonia. She is orientated, her respiratory rate is 31 breaths/minute, blood pressure is 128/74 mmHg and oxygen saturation is 94% on air. She can take oral medication and has no major comorbidity, but lives alone. Which place-of-care plan is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Consider same-day hospital referral after discussing her CRB65 risk

Her CRB65 score is 2: one point for age 65 or over and one for a respiratory rate of at least 30 breaths/minute. She has no confusion and neither blood-pressure criterion is met. NICE NG250 classifies a score of 1 or 2 as an intermediate mortality-risk group and recommends using clinical judgement with the score when deciding place of care. For a score of 2 or more, hospital referral should be considered. A normal systolic pressure or moderately preserved oxygen saturation does not cancel the two positive CRB65 components, and radiographic confirmation should not delay an appropriate risk-based decision.

Reference: https://www.nice.org.uk/guidance/ng250/chapter/Recommendations